Ukrainian Physicians Living in Kyiv Hospital During Invasion

 The national pediatric hospital in Kyiv, Ukraine, where onco-ophthalmologist Lesia Lysytsia, MD, works has fallen silent apart from the sounds of bombs and rockets.

She has been living in the hospital with her physician husband, Oleksandr, her two daughters (ages 2 and 5), and their babysitter since the second day of the war on Ukraine. She spoke to MedPage Today over Facebook late Saturday in Kyiv.

Currently, about one-third of the hospital staff are living in the hospital, she said.

The hospital wasn't meant to be an emergency department or to serve adults, but it has changed its "working plans" over the last few days. About 20% of the staff have been trained to manage emergencies and they are helping to train and organize everyone else, she said.

The first night was scary, Lysytsia said. She woke up to a "strange sound" and thought either she was crazy or she was having a nightmare. Then she scrolled Facebook and realized she wasn't alone.

"At first I was scared, really and honestly," she said. Then she began to calm down because what happened was expected, she said. "You cannot live in stress all the time."

And for anyone with children and patients to take care of, there's no choice but to be brave and do the work, Lysytsia added.

On Thursday, she worked in the hospital while her children stayed in a bomb shelter, but being separated was too nerve-wracking for her and her husband. So on Friday, they brought their children to the hospital.

The hospital tried to evacuate as many patients as possible to Lviv in western Ukraine and to Poland, but some patients can't be moved because they are on 24-hour infusions or are otherwise unstable.

Routine surgeries have been suspended. They also cannot perform organ transplants, because so many roads have been destroyed and because it's resource intensive, she said. They canceled three unrelated stem cell transfusions, because the donor marrow cannot be delivered from Germany and Poland. Transfusions from related donors who are near enough to the hospital can be performed, but even those will likely stop because it's risky and because of restrictions on movement around the city, she said.

The mother of one patient was frustrated because she thought her child's physician had abandoned them out of fear, Lysytsia said. But in reality the doctor lives near the airport in a region that had been attacked, and the bridge connecting her city with Kyiv was destroyed. "She physically cannot [come] do the work," although she is still trying, Lysytsia said.

All the entrances to the hospital are closed, but there is someone who can direct patients and doctors into the hospital in an emergency.

Asked what's changed over the last few days, Lysytsia said: "Everything." There was her life before the attacks started and then after; the only thing that hasn't changed is that patients still need care.

Typically there are a lot of activities and even celebrations for the kids in the hospital, but all of that has stopped. On Friday night, Lysytsia recalled, they couldn't sleep from 2 a.m. to 5 a.m. because of all the noise from guns and bombs.

She and her husband take naps whenever they can. When they gather in the evenings, no one talks about work; everyone is reading the news and trying to find out whether their families and relatives are safe.

All of the patients had to be moved underground except for those in intensive care, including a patient who was hit in one of the attacks and had an operation on Friday. A nurse and one doctor stayed with him.

Over the weekend, the hospital helped at least one family wounded in the attacks, but one of the three young children died before arriving at the hospital, she said.

Two of the hospital's usual patients can't access their oncology treatments because they were at home when the attacks started and now can't reach Lysytsia's hospital or the one in Lviv. While staff can track how many people die in the hospital, they aren't sure how many people are dying for lack of treatment, and that's a problem, she said.

She did not want to say how many patients were currently in the hospital for safety reasons. A psychologist who typically works with oncology patients and their families is now helping hospital staff as well.

Lysytsia said her daughters have been brave, and while not always the best-behaved, they stay put when she tells them not to move, quiet down when she asks them to, and eat whatever she gives them.

Most importantly, while they are definitely afraid, they understand when Lysytsia tells them she has to leave to help other sick children. They tell her to do her work and come back to them as quickly as possible. On Saturday, Lysytsia's older daughter told her she wants to be a doctor too.

Lysytsia and her family will stay in the hospital for as long as they're needed.

"We realize that we need to be brave and stay 'til the end, because if we do not stay 'til the end, then we lose everything we have," she said.

https://www.medpagetoday.com/special-reports/exclusives/97415